Thorpe Gabrielle, McArthur Margaret, Richardson Barbara
School of Allied Health Professions, University of East Anglia, Norwich, UK.
J Adv Nurs. 2009 Sep;65(9):1778-89. doi: 10.1111/j.1365-2648.2009.05059.x.
This paper is a report of a literature review conducted to answer the question 'How has the experience of bodily change following stoma formation been explored and interpreted through existing qualitative research?'.
A faecal stoma alters the function, appearance and sensation of the body. Quantitative research highlights the importance of bodily change following stoma formation but is limited in being able to explore what this experience means to ostomists. Qualitative research can identify ways in which ostomists experience their changed body but a conceptual framework of their experience drawn from qualitative findings which can inform patient-centred care has not yet been identified.
The Amed, ASSIA, CINAHL, Embase, Medline and Psycinfo databases were searched from inception to April 2009 using predefined inclusion criteria. Of 144 papers identified, 11 were selected for review. An interpretive review methodology for qualitative research synthesis was employed.
Three broad themes of bodily experience following stoma formation were identified: loss of embodied wholeness, awareness of a disrupted lived body and disrupted bodily confidence. These highlight the impact of the experience of living with a stoma on the embodied self and the ostomist's embodiment within their lifeworld.
A loss of embodied wholeness which underpins the experience of stoma formation can be represented through awareness of the disrupted lived body and impact on the lifeworld. Findings suggest the need for further research to identify a comprehensive conceptualization of bodily change, which can more closely match healthcare service to individual patient need.
本文是一项文献综述报告,旨在回答“通过现有的定性研究,造口形成后身体变化的体验是如何被探索和解读的?”这一问题。
粪便造口会改变身体的功能、外观和感觉。定量研究强调了造口形成后身体变化的重要性,但在探索这种体验对造口者意味着什么方面存在局限性。定性研究可以确定造口者体验其身体变化的方式,但尚未从定性研究结果中得出一个能够为以患者为中心的护理提供信息的关于他们体验的概念框架。
使用预先确定的纳入标准,检索了Amed、ASSIA、CINAHL、Embase、Medline和Psycinfo数据库,时间跨度从建库至2009年4月。在检索到的144篇论文中,选出11篇进行综述。采用定性研究综合的解释性综述方法。
确定了造口形成后身体体验的三个广泛主题:身体整体性的丧失、对生活身体受干扰的意识以及身体信心的受挫。这些突出了造口生活体验对身体自我以及造口者在其生活世界中的体现所产生的影响。
造口形成体验所基于的身体整体性丧失,可以通过对生活身体受干扰的意识以及对生活世界的影响来体现。研究结果表明需要进一步开展研究,以确定身体变化的全面概念化,从而使医疗服务更能贴近个体患者的需求。